Changing the Monkey's Head to an Ice City Professor's "Medical Rhapsody"

【Abstract】June 13, 39th Annual Meeting of the College of Neurologists and Orthopedic Physicians, USA. Italian doctor Sergio, who became popular because of the "human body change"? Canavero sat on the ground in front of the first row and gave him a thumbs up as he listened to Ren Xiaoping, a professor of microsurgery at Harbin Medical University in China, explain his "animal head-changing" experiment.

Life Newspaper reporter Xue Hongli

This is the first official meeting between two "science maniacs", and they are both invited to participate in the annual meeting because of "head changing". The difference is that Ren Xiaoping is now completing a head replacement for mice, medically known as "allogeneic head reconstruction", and is continuing to delve into the subject; Canavero expects to use the procedure in 2017 on a 30-year-old Russian with hereditary muscular dystrophy.

It sounds a bit like the story in "Liaozhai", or more like the human cutting magic, but this is a real medical technique.

Is it really feasible to change people's heads? How is this surgery done? With all kinds of questions, on the afternoon of the 14th, the reporter met Professor Ren Xiaoping, who had just returned to Harbin from the United States, and unveiled the secrets for you one by one.

The mythical "head-changing technique"

1

Many children who had watched "Liaozhai" at that time had hidden in the bed and nervously peeked at Judge Lu changing the head of a beautiful woman for Zhu Erdan's wife. Such shots are very classic, whether in the old version or the new version of "Liaozhai", they have appeared...

2

Compared with Judge Lu's pen with scalpel effect, Sun Wukong's "medical skills" are higher. In "Journey to the West", the Tang monks and apprentices pass by Che Chi Guo, Sun Wukong and the monster fight, Lao Sun cut off his head and re-connected to the neck, and the "unlucky" youkai, after beheading, was taken away by the dog conjured by Sun Wukong...

3

If you don't learn the art, you will come out to mix, and there is Shen Gongbao in the old version of the "List of Fengshen Gods". In episode 12, Shen Gongbao, in order to persuade Xi Bohou not to "Xing zhou and cut the silk", actually used the "head cutting and regeneration" as a bet, not wanting his head to be taken away by the crane of the Antarctic Immortal, and begged for a long time, and the Antarctic Immortal returned the head to him.

4

For "changing heads", if you think that only in Chinese mythology, you are wrong, and you can also find it in foreign film and television works. In "Return to the Land of Oz", there is a picture of a witch changing her head, she puts a lot of her head in the cupboard, and changing her head is as easy as changing clothes!

Professor Ren Xiaoping of Harbin Medical University

He once changed the head for a thousand rats

Does "changing heads" sound crazy? In fact, Ren Xiaoping has been quietly engaged in this research for nearly 20 years, if it were not for the Italian doctor Canavero's intention to implement the world's first human head transplant in 2017, Ren Xiaoping would not have been exposed to the public so intensively. In the past 20 years, Ren Xiaoping has not only participated in the world's first hand transplantation, personally implemented the world's first rat head transplant, but also planned to change the monkey's head this year...

"Rhapsody" begins with a human hand transplant

Ren Xiaoping was spotted by the media, which was an accident. When the news that The Italian doctor Canavero was going to "change his head" was announced, the Wall Street Journal learned Ren Xiaoping's name from a published academic paper and reported on him in June this year. Then, a number of domestic and foreign media published translations and interviews, and since then, Ren Xiaoping and his research topics have attracted much attention.

Before the idea of changing people's heads came up, Ren Xiaoping and Canavero did not intersect. Why did he choose such a "strange" subject to study, and did it for 20 years? Ren Xiaoping said that his embarkation on this road was actually an "accident".

In 1996, Ren Xiaoping, who worked in the Orthopedic Department of the First Hospital of Harbin, went abroad to study abroad and came to the University of Louisville Medical School in the United States, where there was a world-famous hand microsurgery center, and one of the most challenging research was being carried out at that time - transplanting the forearm of pigs. Ren Xiaoping happened to join the team and began the research of "compound tissue organ transplantation".

Ren Xiaoping recalled that researchers should use pigs to establish animal experimental models for long-term research on immunological drug responses, rejection monitoring, and postoperative functional recovery after transplantation. If this study is successful, it will lay the foundation for human limb transplant technology. However, because compound tissue transplantation is different from single organ transplantation such as heart, kidney and liver, the problems involved are more complex, so the challenge is very large. Previously, in the field of composite tissue transplantation, not only was there a small number of scientific research teams, but there had been no successful precedent. Fortunately, Ren Xiaoping made a breakthrough after entering the team.

Previously, the transplantation scheme of the researchers was to directly disconnect the forearm of the pig, but after the operation, the movement of the pig could not be controlled, and the pig would soon fracture again. According to the requirements of the American Society for the Protection of Animals, in order to avoid the suffering of experimental pigs, the pigs must be put to death at this time. "If the transplant is not successful, the 'animal model' for further research cannot be established, and there is no further in-depth research." Ren Xiaoping said his first task at the center was to improve the operational plan. According to the technical principle of compound tissue flap technology previously mastered in China, Ren Xiaoping designed a method of intercepting only the radial part of the forearm, retaining the ulnar side, wrist joint and elbow joint, and as a result, the disability rate caused by sports injuries after surgery was really reduced. The experiment was successful, and the subsequent anti-immune response could be carried out.

In early 1999, based on a series of anti-immune response studies, the Hand Microsurgery Center of the University of Louisville School of Medicine successfully completed the world's first hand transplant. Now, the patient's arm has survived for 16 years and can live normally, making it the longest surviving hand transplant case to date.

At that time, Ren Xiaoping was also involved in this transplant, and it was from then on that he came up with the idea of "changing his head".

The current record for rat head-swapping is one day

In 2012, as a special talent introduced, Ren Xiaoping, who had lived and worked in the United States for 16 years, returned to Harbin Medical University to work.

In July 2013, Ren Xiaoping led the scientific research team he set up in Harbin to complete the world's first rat head transplant on the basis of discovering new non-ischemic cardiac protection phenomena, proposing the theory of long-range cardiac protection induced by the meridian-autonomic reflex arc, and the success of the world's first face transplant.

For this operation, there are reports that after 10 hours of busy hunching back in front of the operating table, Ren Xiaoping straightened up and looked at his patient, a small black rat with a new brown head. When he removed the respirator from the rat's throat, the rat's head began to instinctively breathe with the unfamiliar body. Professor Ren recalled that after an hour, the rat's body trembled; after another few hours, the rat opened its eyes.

"This means that after the operation, the little mouse lived!" No matter how many minutes or hours you live, it provides the possibility for the next step of in-depth research. Ren Xiaoping said that he has done nearly 1,000 surgeries like this over the years, and he wants to let the rats who received the head transplant survive longer, and the current record high is one day.

Talking about the mood after the success of changing the head of the mouse for the first time, Ren Xiaoping's reaction was relatively flat, "Happiness is certain, but these are based on countless experiments and related studies, so it is not particularly exciting." Moreover, what is the concept of success, living, how long to live, how to live, when to apply to the clinic, there is still a long way to go..."

Ren Xiaoping plans to change the monkey's head this year, but because he is still in the stage of surgical plan design, he does not want to talk about it. I only hope that neither I nor Canavero can create a "miracle" so that this technology can finally be used in the clinic, saving those with spinal cord injuries, advanced cancer and congenital muscular dystrophy disease...

Italian doctors face N kinds of "challenges" in changing their heads

Can "Heavenly Surgery" really be realized?

Italian doctor Canavero named the first human "head replacement" he was going to perform as "HEAVEN", which Ren Xiaoping translated as "heavenly surgery". Many people are full of questions and reverie about "Heavenly Surgery". Some people say that it may be successful; some people say that it is just a gimmick; others ask, change the head, is he still him? For these problems, Ren Xiaoping, who is also engaged in the study of "changing heads", has his own analysis and insights.

There are three major technical difficulties to overcome

Reporter: Do you think dr. Canavero has a good chance of changing his head?

Ren Xiaoping: I neither affirm nor deny his approach. Scientific development itself is full of opportunities and chances, and it is not excluded that Canavero can really create miracles. What I want to do now is pre-clinical basic experiments, and there is no contradiction between clinical advance and in-depth research in animal experiments.

Reporter: Many reports about Canavero have detailed his human "head replacement" program, such as head and neck separation in deep hypothermia and anesthesia, reducing spinal cord injury with a very sharp scalpel, and then using a substance called polyethylene glycol to bond to achieve spinal cord fusion. What other challenges do you have to face?

Ren Xiaoping: To successfully perform this operation, Canavero must overcome three obstacles at the technical level: one is the regeneration of the central nervous system, the other is the problem of immune rejection, and the third is the problem of cryopreservation of the brain and the problem of ischemia and reperfusion injury. For example, the problem of central nervous system regeneration, traditional medicine believes that it can not be regenerated, but the development of medicine in the past decade is gradually overturning this understanding. On the premise of regeneration, Canavero is designed to achieve spinal cord fusion with polyethylene glycol, ensuring that subsequent nerve transmission is not damaged. Although this worked well in animals with damaged spines, it is unknown whether it will work in humans. There is also the problem of immune rejection, and although progress has been made in the transplantation of composite tissues such as hands and faces, the head is more complex, and it is uncertain whether the same regimen is feasible. The prevention of ischemia-reperfusion injury in the brain has not been studied accordingly.

Ethical approval is required for surgery

Reporter: I heard that as soon as the news of changing people's heads came out, they faced a lot of ethical controversies?

Ren Xiaoping: Yes, the controversy mainly focuses on the medical and social cognitive level. Someone asked, A provides the head, B provides the body, after the transplant he is A or B? Someone asked him if he still had memories of the past? Some people also ask if the personality will change? What about blood transfusions? In fact, after the transplantation, from the perspective of thinking, the new individual is still A, and the memory is also A, but he dominates the body that B once had. Personality may change, but so can other surgeries. As for blood transfusions, there is a strict matching before surgery, so there is no need to worry. In addition, the operation must be approved by the ethics committee of the place where it is carried out, which is also an obstacle for Canavero to face, and whether it can be approved or not depends on where the operation is finally carried out.

Reporter: Some people question the question of who the transplanter's offspring are, and some people think that this will make the transplanter, that is, the person with the main body, face a more uncomfortable state of mind and side effects than death.

Ren Xiaoping: Head replacement surgery should be "body replacement surgery" exactly, because the head is the main body. After surgery, the patient does need psychological adjustment of self-acceptance, just as the phantom limb of an amputee also needs psychological adjustment. As for the issue of offspring, sperm donation and artificial insemination are not involved in ethical controversy now.

Reporter: It is said that some scholars believe that there are few and far few somatic donors, even if the transplant can be successful, using this "head-changing" technique to save a quadriplegic person is far less valuable than organ transplantation can save multiple lives?

Ren Xiaoping: The purpose of changing heads is to master a technology that is more meaningful to the maintenance of human life. It's not about how many people have to perform this surgery, but if someone needs such surgery, we can do it. Many scientific experiments have been questioned, such as heart transplantation, kidney transplantation, etc., and changing heads also needs to go through such a process.